43 research outputs found
Calvin Wai-Loon Ho: Juridification in Bioethics: Governance of Human Pluripotent Cell Research; London: Imperial College Press, 2016.
Calvin Wai-Loon Ho: Juridification in Bioethics: Governance of Human Pluripotent Cell Research; London: Imperial College Press, 2016.
The Influence of Medical and Nonmedical Factors to the Progression of Renal Osteodystrophy
We report a 13-year-old boy hospitalized for the first time at the age of 17 months with clinical and laboratory signs of chronic kidney disease (CKD) and renal osteodystrophy caused by severe obstructive uropathy of the single kidney. Prevention and treatment of renal osteodystrophy has been target for aggressive therapy and the great challenge for pediatric nephrologists. The outcome of the therapy of renal osteodystrophy is influenced by medical and non ā medical factors. It was concluded that the place of living (in our example a small village distant from primary care physicians, far from the social care professionals and far from the hospital), inferior social and economical status with inadequate nutrition present negative factors that contributed to the outcome and development of CKD and its complications as is renal osteodystrohy. The coordination of medical and non ā medical professionals is necessary on the primary and secondary level to achieve positive results of therapy in patients with CKD
Vaccination and communication
Cijepljenje je najdjelotvornija metoda u prevenciji zaraznih bolesti, projekt javnog zdravstva proÅ”log stoljeÄa koji je spasio dva do tri milijuna djece godiÅ”nje diljem svijeta. Iako je cijepljenje zakonski obvezno u velikom broju zemalja i unatoÄ evidentnim epidemioloÅ”kim pokazateljima djelotvornosti cjepiva koji se oÄituju u znatno manjoj incidenciji preventibilnih djeÄjih zaraznih bolesti (eradikacija velikih boginja, eradikacija polia u velikom dijelu svijeta), sve je veÄi broj roditelja koji odbijaju cijepljenje svojeg djeteta Å”to je rezultiralo porastom broja necijepljene djece i pojavom veÄih ili manjih epidemija preventibilnih djeÄjih zaraznih bolesti. Razlog sve veÄeg broja necijepljene djece može se naÄi u strahu roditelja od nuspojava cjepiva i sumnji u djelotvornost cijepljenja, neadekvatnoj komunikaciji sa zdravstvenim djelatnicima i priklanjanju dobivanja informacija od strane antivakcinalnih pokreta. Roditelji mogu dobiti informacije iz razliÄitih izvora: od djelatnika javnog zdravstva, pedijatara i drugih zdravstvenih radnika koji rade s djecom, Älanova obitelji, prijatelja, medija (tiskovnih, TV), blogova, razliÄitih internetskih izvora, interesnih skupina i udruga, antivakcinalnih pokreta. Prema recentnim istraživanjima, lijeÄnici su joÅ” uvijek preferirani izvor informacija od kojeg roditelji žele dobiti informaciju o cijepljenju. Iz tog razloga dužnost je lijeÄnika poznavati moguÄe modele komunikacije kako bi mogao pružati kvalitetnu informaciju vezanu uz cijepljenje. U ovom radu navedeno je nekoliko moguÄih pristupa i naÄina komunikacije lijeÄnika s roditeljima djece koja se cijepe. Analizom literature doÅ”li smo do saznanja kako nema jedinstvenog, standardiziranog naÄina komunikacije s roditeljima koji odbijaju cijepljenje. Svaki lijeÄnik,poznavajuÄi temelje komunikacijskih modela i pristupa, modelirat Äe svoj pristup ovisno o situaciji i sugovorniku.Vaccination is one of the most effective methods in the prevention of infectious diseases, the last century public health project which accounts for the prevention of 2 to 3 million deaths in children each year worldwide. Despite the fact that vaccination is mandatory in great number of countries and despite the evident epidemiological data that indicate the effectiveness of vaccination which is reflected in the significantly lower incidence of preventable childhood infectious diseases (eradication of smallpox, eradication of polio in the most countries of the world), there is an increasing number of parents who refuse to vaccinate their child which results in increased number of unvaccinated children and occurrence of greater or smaller epidemic of preventable childhood diseases. The reason for increased number of unvaccinated children could be explained by the parents fear of vaccine side effects and by doubts in the effectiveness of vaccination, the inadequate communication with health care workers and wish to receive information from anti vaccination movements. The parents could receive the information from different sources: from public health employers, from the family members, from friends, media, blogs, different Internet sources, and from Internet social network, from different interest groups and from anti-vaccine movements. According to the recent resources, the physicians are still the most preferable source of information from whom the parents want to receive the information about the vaccination. Therefore, the duty of physicians is to know the possible models of communication in order to provide the qualitative information regarding the vaccination. In this paper several possible approaches and communication methods between doctors and parents are mentioned. Analyzing the literature, we have found out that there is no unique and standardized way of communication with vaccine-hesitant parents. Every physician should develop his or her way of communication regarding the situation and interlocutor, knowing the basic communication models and approaches
The Importance of the Assessment of Quality of Life in Glaucoma Patients
Glaucoma is a chronic, progressive eye disorder that can lead to visual impairment and blindness. The projection of glaucoma prevalence in the world suggests that in 2020, 79,6 million of people will have glaucoma, 11,2 million of them will be bilaterally blind. The chronic disease, such as glaucoma, affects the different roles of a patient in everyday life and his/her well-being. Quality of Life (QoL) helps to define the inability of performing specific task that is most important to patient. Patientsā perspective on their visual impairment and well-being are essential in the planning of management of glaucoma. The assessment of QoL should be standard procedure in the management of glaucoma patients. In clinical practice it should represent a gold standard in the care of chronic patients and a proof of fulfilling the patientsā rights. The assessments of QoL should serve as a tool for good clinical practice, for respecting the patientsā rights, and respect for the value of human life in general
The influence of erythropoietin treatment on oxidative stress parameters in cortex of rats exposed to transient middle cerebral artery occlusion
Background and Purpose: Erythropoietin (Epo) plays a central role in
process of erythropoiesis. Recently, its neuroprotective potential was reported in various experimental models of brain damage. However, the mechanism of Epo protection is still unclear. In the present study, we examined the effect of Epo administration on lipid peroxidation levels and antioxidant enzymesā (superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px)) activities in rat cortex following focal cerebral ischemia.
Material and Methods: Focal cerebral ischemia was induced in male
HanoverWistar rats (250ā350 g) by right middle cerebral artery occlusion (MCAO) model for 1 hr. After 23 hrs of reperfusion, ischemic animals were sacrificed and the levels of lipid peroxidation, SOD and GSH-Px activities were determined spectrophotometrically in the right cortex. Ischemic animals received either vehicle or Epo (5000 IU/kg, intraperitoneally) immediately or 3 hrs after MCAO, and were sacrificed 23 hrs or 21 hrs later, respectively. Sham operated, vehicle treated animals served as the control group.
Results and Conclusion: Focal cerebral ischemia significantly increased the level of oxidative lipid damage parameters in the right cortex as compared to the control group without affecting SOD and GSH-Px activities. The decrease in level of lipid peroxidation after Epo treatment was registered but it was not statistically significant. Our results indicate that focal cerebral ischemia caused neuronal damage in the right cortex and that Epo treatment was not effective in preventing above mentioned alteration
The influence of erythropoietin treatment on oxidative stress parameters in cortex of rats exposed to transient middle cerebral artery occlusion
Background and Purpose: Erythropoietin (Epo) plays a central role in
process of erythropoiesis. Recently, its neuroprotective potential was reported in various experimental models of brain damage. However, the mechanism of Epo protection is still unclear. In the present study, we examined the effect of Epo administration on lipid peroxidation levels and antioxidant enzymesā (superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px)) activities in rat cortex following focal cerebral ischemia.
Material and Methods: Focal cerebral ischemia was induced in male
HanoverWistar rats (250ā350 g) by right middle cerebral artery occlusion (MCAO) model for 1 hr. After 23 hrs of reperfusion, ischemic animals were sacrificed and the levels of lipid peroxidation, SOD and GSH-Px activities were determined spectrophotometrically in the right cortex. Ischemic animals received either vehicle or Epo (5000 IU/kg, intraperitoneally) immediately or 3 hrs after MCAO, and were sacrificed 23 hrs or 21 hrs later, respectively. Sham operated, vehicle treated animals served as the control group.
Results and Conclusion: Focal cerebral ischemia significantly increased the level of oxidative lipid damage parameters in the right cortex as compared to the control group without affecting SOD and GSH-Px activities. The decrease in level of lipid peroxidation after Epo treatment was registered but it was not statistically significant. Our results indicate that focal cerebral ischemia caused neuronal damage in the right cortex and that Epo treatment was not effective in preventing above mentioned alteration
UNESCO, bioethics and child
Pod okriljem UNESCO-a su donese tri glavne meÄunarodne deklaracije iz podruÄja bioetike s ciljem zaÅ”tite Ā»prirodnog dostojanstva, jednakih i neotuÄivih prava svih Älanova ljudske obiteljiĀ«. Djeca su posebno osjetljiva kategorija Ā»ljudske obiteljiĀ« Äija su se prava pokuÅ”ala zaÅ”titi donijetim deklaracijama, bilo na direktan ili indirektan naÄin, poÄevÅ”i od OpÄe deklaracije o ljudskim pravima. ProÅ”lo je dvadeset godina nakon donoÅ”enja Ā»Konvencija ujedinjenih naroda o pravima djeceĀ« (20. studeni, 1989.). U ovom Äemo se radu osvrnuti na temeljna prava djeteta prema UNESCO-vim dokumentima.UNESCO has adopted three principal international bioethics declarations with the purpose to protect Ā»the inherent dignity of the equal and inalienable rights of all members of the human familyĀ«. Children are a particularly sensitive category of the Ā»human familyĀ« whose rights were attempted to be protected through declarations, directly or indirectly, starting with the Universal Declarations on Human Rights. It has been twenty years since adopting the Ā»Convention on the Rights of the ChildĀ« by the UN (20 November 1989). Th is paper shall look into the basic rights of the child in accordance with UNESCOās documents
Croatian Childrenās Views towards Importance of Health Care Information
The aim of research was to investigate: the need for health care information of Croatian adolescents aged from 13 to
18 years; the difference in evaluation of the frequency of receiving information between hospitalized and healthy children;
if the hospitalized children expectations about the frequency of receiving health care information differed significantly
from information they have actually received; whose information was most comprehensible to the hospitalized
children (doctors, parents, other health care givers). The children were either hospitalized in the pediatrics departments
or were high schools pupils (healthy children). The hospitalized children Ā»Completely agreedĀ« (92.7%) with the statement
Ā»When I am sick, I should receive information about my healthĀ« in comparison to the healthy children (85.1%). In
comparison to healthy children, the hospitalized children assessed that doctors, other health care givers and parents
should give them information more frequently. The experience of hospitalized children indicate that they received less information
then they have actually excepted. The information received from doctors was mostly in correlation with the understanding
of this information. We concluded that the children want to be informed about their health, especially hospitalized
children. Health care professionals should offer understandable health care information according to the childrenās
expectation
HETERO- / AUTONOMY IN THE CONTEXT OF SELF/DETERMINISM OF BIOLOGICAL TESTAMENTS
Suvremeni pogled na umiranje obilježen je nizom neizvjesnih i teÅ”kih pitanja koja proizlaze iz kliniÄkoga konteksta, pravne i bioetiÄke domene donoÅ”enja teÅ”kih egzistencijalnih odluka vezanih uz posljednje životne trenutke, a napose s obzirom na medicinske intervencije izbora āskrbi na kraju životaā.
Taj korak zahtijeva punu racionalnost slobodne autonomije, koja u odreÄenim trenucima može biti znatno naruÅ”ena gubitkom fiziÄkih i/li mentalnih sposobnosti, uvjetovanih pojedinim bolestima. Stoga bi bolesnici trebali imati zakonodavnu moguÄnost jasno priopÄiti svoje želje u vezi sa zahtijevanim tretmanom ili njegovim distanazijskim povlaÄenjem u unaprijed pripremljenim smjernicama anticipiranih medicinskih odredbi bioloÅ”kih oporuka za (ne)postupanje ili imenovanje surogatnog opunomoÄenika kao zastupnika u (ne)izboru lijeÄenja u sluÄaju ograniÄene sposobnosti odluÄivanja.
Potpisana bioloÅ”ka oporuka mogla bi uvelike pridonijeti pozitivno dostojanstvenijom modusu samodeterminiranog naÄina umiranja, poÅ”tujuÄi ākulturu životaā, sukladnog onom koji je odabir autonomnih pacijentovih vrijednosti skrbi na kraju života, koji Äesto mogu uÄi u koliziju iz heteronomne perspektive surogatnih odluÄitelja.
BioloÅ”kim bi se oporukama viÅ”estruko nadvladale i teÅ”koÄe kliniÄkih dilema egzistencijalnih odluka: lijeÄnicima bi se olakÅ”ao odabir skrbi u hitnim planovima zdravstvene njege u kriznim situacijama; pacijentima bi pružale jamstvo provedbe njihova samoodreÄenja; dok bi surogatne odluÄitelje uvelike oslobodili pritiska odgovornosti.A contemporary view of death is characterized by a sequence of uncertain and difficult questions arising from the clinical context, out of the legal and bioethical domains of taking difficult existential decisions related to the last moments of human life. This step requires a full rationality of free autonomy, which can be significantly disturbed by the loss of mental ability, conditioned by certain illnesses in certain moments. Therefore, patients should have a legislative opportunity to clearly state their wishes regarding the required treatment or the withdrawal in previously prepared guidelines of anticipated medical dispositions of the biological testaments for (non) treatment or the appointment of a surrogate representative of treatment choice at the terminal phase, in case of limited decision-making ability. The signed biological will could greatly contribute to a dignified mode of dying, consistent with the choice of autonomous patientās end-of-life care values, which can often enter into collision from a heteronomous perspective of a surrogate decision-maker. With the biological will we could overwhelmingly overcome the difficulties of the clinical dilemma of existential decisions: Physicians would be more reliant on choosing care in urgent health care plans in crisis situations, the patients could provide the assurance of their self-determination while the surrogate rulers could be largely released from the pressure of responsibilit